ANGELA ISKANDAR ANAK-AGUNG-GEDE (NPI# 1790912103) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790912103 |
| Entity Type | Individual |
| Full Name | ANGELA ISKANDAR ANAK-AGUNG-GEDE |
| Other Name | ANGELA GRACIA ISKANDAR |
| Credential | PA |
| Practice Address |
480 4th Avenue Suite 307 Chula Vista CA 91910 |
| Practice Telephone | 6194263240 |
| Practice Fax Number | 6194265964 |
| Mailing Telephone | 6194263240 |
| Mailing Fax Number | 6194265964 |
| Enumeration Date | 2009-06-12 |
| Last Update Date | 2011-09-20 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
19998 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | STATE LICENSE | 19998 | 01 |
| Street Address |
480 4TH AVENUE SUITE 307 |
| City | CHULA VISTA |
| State | CA |
| Zip Code | 91910 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477194264 | Joshua Maurice Hayden | Dental Hygienist | 678 Thrid Ave, Chula Vista, CA 91910 | 2019-10-02 |
| 1255980504 | Samantha Bernaldo | Dental Hygienist | 668 Third Ave, Chula Vista, CA 91910 | 2019-09-10 |
| 1073179529 | Roshni Kakaiya | Student in an Organized Health Care Education/Training Program | 435 H Street, Cv112, Chula Vista, CA 91910 | 2019-05-09 |
| 1598232506 | Naria Le Mire | Dietitian, Registered | 288 Broadway #141a, Chula Vista, CA 91910 | 2018-10-28 |
| 1730676727 | Pei Chi Chain | Optometrist | 324 F Street., Chula Vista, CA 91910 | 2018-04-16 |
| 1104332741 | Teodoro David Pena | Dentist | 510 Broadway Ste 4-5, Chula Vista, CA 91910 | 2017-12-19 |
| 1538684865 | Camille Cooke | Counselor | 430 F. Street, Chula Vista, CA 91910 | 2017-08-08 |
| 1184146094 | Alexandra Lynn Scovill | Optometrist | Castillejos Eye Institute Medical Group, 342 F Street, Chula Vista, CA 91910 | 2017-07-12 |
| 1396270583 | Tam Trieu | Pharmacist | 555 Broaway Suite 1054, Chula Vista, CA 91910 | 2017-04-25 |
| 1548792815 | Sabrina Owens | Family Medicine | 499 H Street Cv112, Chula Vista, CA 91910 | 2017-03-28 |
| Find all providers in zip 91910 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922505775 | Christopher B Vargas | Physician Assistant | 2452 Fenton St Ste C203, Chula Vista, CA 91914-3599 | 2018-04-09 |
| 1295273639 | Mobile Wound Care-san Diego Nd | Physician Assistant | 1415 Santa Diana Rd, Chula Vista, CA 91913-2745 | 2017-02-06 |
| 1790905438 | Nercy Manez | Physician Assistant | 2015 Birch Rd, Suite 509, Chula Vista, CA 91915-2002 | 2007-04-26 |
| 1306470372 | Rachel Todd | Physician Assistant | 480 4th Ave Ste 307, Chula Vista, CA 91910-4403 | 2020-02-27 |
| 1902359607 | Laura Bradley | Physician Assistant | 480 4th Ave, Suite 307, Chula Vista, CA 91910-4410 | 2016-07-28 |
| 1306202320 | Jennifer Leigh Willins | Physician Assistant | 1295 Broadway, Chula Vista, CA 91911-2982 | 2016-01-06 |
| 1407211881 | Ernest Ritualo Mejia | Physician Assistant | 480 4th Ave, Suite 202, Chula Vista, CA 91910-4410 | 2015-12-29 |
| 1518375179 | Heather Doulaki | Physician Assistant | 971 Lane Ave, Chula Vista, CA 91914-3501 | 2014-07-28 |
| 1417223165 | Jeanna Cash Tapia | Physician Assistant | 2452 Fenton St, Suite C101, Chula Vista, CA 91914-3599 | 2012-03-27 |
| 1639459720 | Eric R Briones | Physician Assistant | 1400 E Palomar St, Chula Vista, CA 91913-1800 | 2011-08-22 |
| Find all providers in CHULA VISTA | ||||
| City | CHULA VISTA |
| Zip Code | 91910 |
Please comment or provide details below to improve the information on ANGELA ISKANDAR ANAK-AGUNG-GEDE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.